Abstract Risk for Alzheimer?s disease is the only cause of death among the top 10 in the US that cannot be prevented, cured or even slowed using medications and is the most expensive chronic disease. Initiated in 2006, the Baltimore Experience Corps Trial (BECT) is the largest randomized controlled trial (N = 702) to examine whether multi-modal social, cognitive, and physical engagement enhanced neurocognitive functions in cognitively intact older adults. The BECT was novel among intervention trials in its appeal to economically disadvantaged adults at elevated risk for Alzheimer?s disease. The trial randomized older adults to show that productive social engagement as volunteers in elementary schools increased lifestyle activity and generative purpose and improved cognition and brain biomarkers for Alzheimer?s disease over two years of exposure. We now need to evaluate whether the two-year short-term effects in relatively healthy aging adults collectively were associated with longer-term health benefits 10-12 years later as these at-risk individuals enter their 80th and 90th decades of life. We will determine whether increased social engagement in Experience Corps between 2006-2012 led to long-term lower risk for Alzheimer?s disease, reductions in Medical Care expenditures, maintained functional and financial independence, improved quality of life and social network stability, and lower mortality. To achieve these goals, we will leverage a wide range of linked data, including Medicare and Medicaid Claims, Maryland CRISP healthcare data, National Death Index (NDI), financial records, and a low-cost 10-12-year follow-up telephone interview to assess cognition, function, health, lifestyle and social connectivity. This study will allow us to examine the long-term impact of a social engagement program on key outcomes related to risk for Alzheimer?s disease and dementia risk, functional and financial independence, quality of life, and mortality.